Lips and Teeth:  Relationships that are Important When Planning for Lip Augmentation

The number one concern that most women have when they visit a plastic surgeon when it comes to lip size is “Please make my upper lip bigger, but I don’t want it to look unnatural.”  In an accompanying article we explored the relative balance and size of the upper and lower lips that help define what is natural to avoid the risk of overfilling.  These principles will be briefly summarized herein before exploring related principles of how lips look in dynamic and repose states as well as how the lips interact with the teeth to generate a natural-appearing result.  In summary on the subject of lip augmentation discussed before in a separate article, the upper lip should almost always be slightly to significantly smaller in vertical height and in anterior projection/protrusion relative to the lower lip.  When this principle is violated the lip result can look devastatingly unnatural.  Accordingly, when a woman comes to the office wanting “just a little bit in my upper lip” she does not understand the risk involved without balancing it to the bottom lip.  In addition, the bottom lip can truly be a hallmark of a beautiful, youthful, pouty look and is far underrated in this potential.

Beyond these principles, lips have a relative proportion to the teeth that must be honored.  With aging the upper lip hangs down over the upper teeth through a process of lengthening.  Therefore, an individual can look even older when the upper lip is augmented because the upper lip now obscures the upper teeth even more after it has been inflated.  Further a full upper lip could simply look unnatural in an older individual no matter how much she undergoes related facial rejuvenation.  I truly believe a very, very full upper lip only looks natural in someone in her early 20s.  Even beyond this period of time, a very full upper lip contour can be a glaringly obvious sign of bad plastic surgery.

Interestingly, the opposite is the case with the bottom lip.  As one ages, the lower lip loses lip competence, or muscle strength, and starts to hang outward showing more bottom teeth.  Therefore, showing bottom teeth can be a sign of aging that is an unpleasant attribute of aging.  Think of an older politician photographed with his mouth open only showing his gnarly bottom teeth and with his upper teeth completely hooded by his hanging upper lip.  Therefore, lower lip augmentation can help not only make someone look youthful at almost any age and still look natural but also benefit the individual by obscuring the lower teeth visibility.

As part of any evaluation for lip augmentation, the physician must consider a patient’s age so that the lips fit that person’s age bracket.  For permanent lip enhancement with silicone treatments it is much preferred to treat someone over 35 years of age and always to err on the side of conservatism to ensure long-term safety and how that lip will age for that person.  Using artistic judgment and knowledge of the above principles can help a physician guide a patient toward a safe and effective long-term result.

Also as part of the initial evaluation, a physician should examine a patient with her mouth open, closed, and smiling.  Lips are dynamic structures that must be respected as such.  They should look natural and better when the lips are open, closed, talking, and smiling.  Too often a physician only judges the lips when they are closed but this can lead to problems when they are in a dynamic state.  The issues of teeth show have already been discussed regarding when the lips are separated and open.  However, what about smiling?  The upper lip becomes a central focus here.  If the person smiles and there is a lot of gummy show, the so-called “gummy smile”, and the lip does not appear to hang too much over the upper teeth when the lips are open then the physician can be slightly more aggressive in treatment of the upper lip to improve this situation.  Finally, I distinctly recall when a patient said to me, “I don’t like it when I smile and my upper lip completely disappears.”  I explained that a normal lip should flatten and either slightly or greatly flatten with smiling.  When it does not, it can be a stigma of a fake lip.  This final consideration to me is something that should not be underappreciated.  Most individuals know a fake lip when they see one but cannot tell why it looks fake.  Hopefully, these principles discussed help to supplement one’s knowledge base as to why a lip can look fake and how to avoid falling into that trap.

Follow the links to learn more about Dr Lam’s lip augmentation, and lip reduction procedures, including before and after photos, videos, lip forums and FAQs, or call 972.312.8188 to schedule a consultation .